by
Jeffrey L. Edleson, Ph.D.
Sandra K. Beeman, Ph.D.M
University of Minnesota
Under a contract from
Department of Children and Family Services
Hennepin County, Minnesota
August, 1999
Appendices to this report are available at www.mincava.umn.edu/link/documents/finrport/investigation.rtf and www.mincava.umn.edu/link/documents/finrport/screen.rtf.
The authors wish to acknowledge the extensive assistance of Annelies Hagemeister, M.A.,
and Lyungai Mbiliyni, M.S.W., in preparing this report.
The issues of child maltreatment and adult domestic violence have separately received extensive public attention in recent years. It is only in the past five years, however, that the relationship between child maltreatment and adult domestic violence has been discussed and studied nationally. Over 30 studies of the link between these two forms of violence show amedian co-occurrence of both forms of violence in 40% of families studied with the range in the majority of studies varying from 30% to 60% of families (Appel & Holden, 1998, Edleson, 1999a).
Concern exists not just for the women and children who are maltreated in these families but also for the children who witness adult violence but are not themselves the victims of physical abuse. Several recent reviews of the research show that children exposed to adult domestic violence may experience a variety of negative developmental outcomes, the severity of which depends on the existence of various risk and protective factors in their environment (Edleson,1999b; Holtzworth-Munroe, Smutzler & Sandin, 1997; Margolin, 1998; Peled & Davis, 1995).
This report reviews local data on the co-occurrence of these two forms of violence and suggests key strategies for improving the response of county and municipal government agencies and community-based non-profit organizations to these families.
Drs. Edleson and Beeman and their research assistants collected information from a variety of sources during the first half of 1999. Information collection included detailed reporting by child protection screeners and investigators in the Hennepin County Department of Children andFamily Services (HCDCFS), consulting with national experts in this area, reviewing published materials on prominent demonstration projects from around the United States and Canada, and holding a series of stakeholder meetings throughout Hennepin County.
Screening and Investigation Findings
During the Spring of 1999, child protection screeners and investigators in HCDCFS reported data on the co-occurrence of child maltreatment and adult domestic violence in their caseloads. Detailed summaries of the methods used, the forms and results appear in Appendix A.
Screeners supplied data on 806 reports of child maltreatment received between March 8 and April 9, 1999. These data indicated that reporters knew of adult domestic violence in 19% of thecases being reported. Reports with domestic violence present were significantly more likely to be investigated than those in which domestic violence was not known. It was found that 66% of reports with known domestic violence were assigned for investigation, whereas 52% of those in which no domestic violence was identified were similarly assigned. "Failure to protect" was significantly more likely to be cited as a condition for assignment when domestic violence was known. In the reports in which domestic violence was known, "failure to protect" was much more likely to be cited as a condition code in cases assigned for investigation (61%) than when domestic violence was not known (22%).
During the next month, from April 12 to May 14, 1999, child protection investigators reported on the co-occurrence of child maltreatment and adult domestic violence in their caseloads. Investigators supplied data on 383 cases, or 60.6% of the investigations initiated during this period.
Adult domestic violence was reported either to the investigator or through other sources inover one-third (36.4%) of the cases for which forms were completed. Among the 177 cases with a finding of child maltreatment, 65.1% also had an indication of domestic violence. There was also a significant difference in maltreatment condition codes for those with domestic violence indicated and those without. Of those cases in which domestic violence was indicated, 10.8% cited physical child abuse, 0% cited sexual abuse, 3.6% cited physical or medical neglect, 9.6% indicated another form of neglect, 34.9% cited failure to protect, and 41% cited an unspecified maltreatment type. More than three-quarters (76.3%) of the cases that were cited as 'failureto protect' contained indications of adult domestic violence. Cases with domestic violence indicated also showed a somewhat higher level of risk (50.7% high risk) when compared to those in which no domestic violence was indicated (33.3% high risk). There were lower percentages of low and intermediate risk cases among those with domestic violence (30.4% low and 18.8% intermediate) compared to cases without indicated domestic violence (40.6% low and 26.1% intermediate). Finally, cases in which domestic violence was indicated, were more likely to have a CPS case opened (45.6%) than were those in which domestic violence was not indicated(24.4%). Conversely, cases that did not have an indication of domestic violence (38.5%) were significantly more likely than those with domestic violence (20.3%) to have the case closed after investigation. About the same percentages of cases with domestic violence (34.2%) and without domestic violence (37.2%) were referred for community services. (See Appendix A formore detail.)
These data indicate that a large number of families in Hennepin County experience the double trauma of child maltreatment and adult domestic violence. The data also reveal that these families are more likely to be the subject of an investigation, to have child maltreatment substantiated, cases opened for service, and to be found at higher risk than other families. They also reveal that a large number of cases with domestic violence present are categorized as "failure to protect" and point to the need for more involved community services and support.
It is important to note that these data may underestimate the actual occurrence of adult domestic violence within families reported to and investigated by child protection. In the case of reports to child protection, many reporters may not be aware of adult domestic violence in the families being reported for child maltreatment. This may be particularly so among reporters who know families within a limited context such as school, day care, or healthcare settings. In the case of child protection investigations, many women may be hesitant toprovide information about their own victimization for fear of further stigmatizing themselves or of increasing the likelihood of their children being removed from their care. Even with these limitations, however, these data provide a rough indication of the co-occurrence of child maltreatment and adult domestic violence among families reported to and investigated by HCDCFS.
Models for Intervention
National Models on Domestic Violence and Child Maltreatment. Increasingly, states are defining children's exposure to domestic violence as a problem. Some states, such as Utah, have new laws that make the commission of adult domestic violence in the presence of a child a separate criminal offense from the assault itself. In California, the presence of children brings enhanced criminal penalties in adult assault cases. The Minnesota Legislature recently expanded the definition of child neglect in the Reporting Law to specifically include exposure to adult domestic violence. This change acknowledges what has long been the practice in many county child protection agencies of accepting certain reports of children's exposure to adult domestic violence as child neglect.
These new laws are part of a larger movement that, over the past 10 years, has resulted in anumber of small, dispersed new efforts to intervene with battered women and abused children. Adding new criminal penalties or screening in more cases is problematic given the data onchildren's exposure to domestic violence (see Edleson, 1999b). The literature reveals a broad continuum of child exposure and shows that many children exposed to domestic violence do not show negative developmental outcomes. It is likely that expanded community services and support are what is needed, not enhanced laws or involvement of the child protection system.
The National Council of Juvenile and Family Court Judges (NCJFCJ) Resource Center on DomesticViolence, Child Protection, and Custody has recently published two lengthy documents reviewing the best of these efforts and suggesting policy and practice guidelines for child welfare agencies, domestic violence programs, and the courts. The first is Emerging Programs forBattered Mothers and Their Children (NCJFCJ, 1998), which showcases 36 programs selected from over 200 that were identified in the United States. A brief summary of some of these programs appears in Appendix B. The second is Effective Intervention in Domestic Violence and Child Maltreatment Cases: Guidelines for Policy and Practice (NCJFCJ, 1999), which offers over 60 recommendations on changes in policy, staff development, information sharing, and practice strategies in cases where child maltreatment and domestic violence co-occur.
Perhaps the most established models exist in the states of Massachusetts and Michigan, both ofwhich have statewide initiatives under way on this issue (see Findlater & Kelly, 1999; Whitney& Davis, 1999). Massachusetts, which has a statewide child protection system, developed aDomestic Violence Program within its Department of Social Services child protection unit. Staffed by 14 domestic violence specialists, they may consult in a variety of ways: sitting in on case service plan conferences, developing safety plans with mothers, providing trainingfor staff, or developing connections to community-based services for families and children.
In the first quarter of 1998, "the specialists received 1,519 consultations involving 1,210 families, of which 670 were new families to the child protection caseload" (Whitney & Davis,1999, p. 162). In one preliminary evaluation of Massachusetts' project, Hangen (1994) found that cases handled by child protection offices with domestic violence specialists on staff were closed in approximately one-third less time than the state average, raising the possibility that addressing adult domestic violence concerns may accelerate the successful completion of case plans. A survey of the Massachusetts CPS system also found high awareness among CPS workers of domestic violence protocols and use of domestic violence specialists in consultations. The survey revealed that 62% of the CPS supervisors had consulted with adomestic violence specialist five or more times (Heller, Gyurina & Rosenbaum, 1997).
The Massachusetts DSS project is part of a larger network of developing services. For example, the Child Witness to Violence Project at Boston Medical Center is a community-based program that focuses on providing direct services to children traumatized by violence. Eighty percent of their clients are children who have witnessed domestic violence. In addition, the statehas recently funded a shelter for battered mothers who are substance abusers (and their children) where both safety and ending substance abuse can be the focus of the work.
Michigan's Families First, the state family preservation program, and the Domestic ViolencePrevention & Treatment Board teamed up to develop extensive cross-training and a close workingrelationship between battered women's shelters and family preservation workers. Starting with five communities, the project has now expanded to include 11 communities with 18 family preservation workers who take referrals directly from battered women's programs and work with the woman to provide safety to both her and her children on exit from the shelter. As of January 1997, 345 battered women and their children had received services, over 90% of whomwere shelter residents (Findlater & Kelly, 1999).
Finally, Miami-Dade County's Juvenile Court has developed a significant intervention project focused on providing court-based services to battered mothers appearing in dependency hearings(see Lecklitner et al., 1999). The Dependency Court Intervention Program for Family Violenceseeks to improve collaboration among child protection, the judiciary, and battered women'sadvocates through intensive outreach efforts with battered mothers whose children have beenabused and neglected. Mothers coming before the court are screened for domestic violence and if it is found are offered voluntary services from a court-based battered women's advocate.
Hennepin County Models. Consultations with local stakeholders (see below) identified anumber of efforts in Hennepin County that provide elements to consider in structuring aresponse to abused children and their battered mothers. These models include programs such as Family Options, Project Child, the Integrated Service Delivery Team (ISDT), the Hennepin Children's Mental Health Collaborative, Child Advocacy Centers such as Cornerhouse in Minneapolis, and Community Assessment Centers such as the planned juvenile assessment center.These programs each represent specialized, multi-agency responses for children and/or their families that are experiencing specific problems, including chemical abusing parents, offenders under age 10, and chronic delinquency. Some are independent non-profit agencies and others are part of county government. They most often provide an array of benefits for children, families, and service systems, including immediate and comprehensive assessment by trained specialists, integrated case management, comprehensive and integrated information on cases, and sometimes specialized services not available elsewhere in the community (OJJDP, 1999;HCMHC, 1999).
Stakeholder Consultations
A wide variety of Hennepin County and national stakeholders were consulted in order to helpidentify issues, barriers and models for successful collaboration around the co-occurrence of child maltreatment and adult domestic. Over 60 professionals in Hennepin County were consulted in over 10 meetings. Stakeholders included county and city attorneys, Domestic Abuse ServiceCenter staff, legal services lawyers, a public defender, battered women's advocates, probation officers, judges, child protection administrators, supervisors, and workers and child welfarefield and permanency planning services supervisors and workers. Hennepin County consultations mostly occurred in group meetings lasting approximately 90 minutes with a series of specific questions addressed to those attending. Field notes were recorded and specific themes are integrated into the recommendations below (see Appendix B for meeting outline, models summarytable, and participant lists).
A series of national stakeholders were also consulted informally, in telephone and face-to-face meetings, over the past six months. These included Susan Schechter at the University of IowaSchool of Social Work, Merry Hofford from the National Council of Juvenile and Family Court Judges, Janet Carter from the Family Violence Prevention Fund, and staff from projects in the states of Massachusetts, Michigan, and Florida. In addition, the authors had previously held extensive discussions in Hennepin County regarding this very issue (see Beeman, Hagemeister &Edleson, 1999).
This report recommends several new levels of activity within Hennepin County to better respond to families where both child maltreatment and woman battering are co-occurring. These recommendations are based on a guiding principle that programs should work to secure the safety, security, and well-being of all victims of family violence (NCJFCJ, 1999). They address a range of families, including children who witness adult domestic violence who may not currently be at high-risk and would not traditionally be served by the child protection system, and children at higher risk who would traditionally be served. These recommendations, therefore, include improving existing services, and creating a new partnership with community services to serve lower-risk children. Suggested responses focus on enhancing capacity to respond to these families, adding new structures for on-going communication between county and municipal departments and community-based non-profit agencies, and new services specifically targeted at these families. The recommendations are made in the context of other new efforts also under way at the County, for example efforts to integrate existing databases and toimplement a structured decision-making process in child maltreatment assessment.
A training program that is on-going and is designed to be delivered to participants from multiple disciplines should be developed and implemented within Hennepin County. Training should be multidisciplinary in nature because so many different professionals interact with these families and cooperation between them is essential to the success of service delivery. Such training could build upon existing training resources in the County and the community aswell as redirect some of these existing efforts toward curricula that include a variety of personnel. Training should be provided to all levels of staff, from supervisors to directservice providers.
Training programs should include basic information on research, theory, and best practice with families in which child maltreatment and woman battering co-occur. Information on the laws pertaining to and responsibilities of various parts of county, municipal, and community systemsthat have contact with these families should also be included. Training should provide skills in domestic violence and/or child abuse assessment, interviewing, safety planning and referral. Training should offer an opportunity for experiential interactions around mock cases so thatan appreciation of the complexity of these families, the systems with which they interact, and the multiple perspectives brought to the table develops among participants. Experiences nationally have shown that cross-training such as proposed here may result in less fragmented services to families (see Whitney & Davis, 1999; Findlater & Kelly, 1999).
The National Council of Juvenile and Family Court Judges has called for specific inter-agency agreements to be developed between child protection agencies, domestic violence programs, and the juvenile courts. These agreements should outline specific roles and responsibilities of each participating agency in responding to these families. A set of meetings that brings together administrators and supervisors from these agencies as well as the Hennepin CountyAttorney's Office, Community Health and Adult Corrections Departments, and the City ofMinneapolis' Health Department should be convened to develop and refine the response to families in which both forms of violence exist. The meetings should continue on a periodic basis to review the success of these agreements.
Communication at the direct service level is addressed in Recommendations 3 and 4.
Clearly, these data indicate that in the screening and investigation processes approximately two-thirds of the cases in which reporters or investigators identified domestic violence are not opened for service within HCDCFS. These data clearly argue the need for appropriate alternative, community-based responses for these families.
These findings call for a different response in which voluntary services and community-based agencies should play a role. Stakeholders were clearly frustrated with the lack of response available to children and families where reports were made but cases ended up being closed orreferred for services. The County's child protection system may not be the best location for such a voluntary, alternative response. New state law entitled the "Alternative ResponsePrograms for Child Protection Assessments or Investigations" (State of Minnesota 1999 SessionLaw, Chap. 242, Art. 8, Sect. 65) permits counties to develop an alternative response to assessment and services that is voluntary to families. The Family Options program, although not targeted specifically to child witnesses to domestic violence, has been a major effort in which such early responses have been successfully implemented.
At the national level, the Child Witness to Violence Project in Boston offers a model that could be adapted in Hennepin County as a specific alternative response to child witnessing of domestic violence (see Appendix D for description). This community-based, non-profit agency works directly with children who have been witness to many forms of community and domestic violence. It also works with their families. A large percentage of their caseload, however, is focused on children exposed to adult domestic violence. The Project takes direct referrals from the child protection system as well as a variety of other professionals and citizens concerned about the children's welfare. Project staff work closely with staff from criminal justice, child welfare, and domestic violence programs in the area.
The County should explore establishing a new community-based program, such as the Child Witness to Violence Project, or expanding the capacity and enhancing the expertise of existing programsin the voluntary, non-profit sector to provide these assessments and services. This idea is not new to Hennepin County. Successful efforts such as Cornerhouse, a child advocacy center and initiatives such as the Children's Mental Health Collaborative and Family Options already exist in the County.
What is envisioned in this recommendation is a separate, community-based service that wouldserve as a centralized assessment, referral and service center for children who have witnesseddomestic violence but may not be at great enough risk to receive HCDCFS services. This program may be a stand-alone agency or a collaborative of existing domestic violence andchild-oriented programs in the County. It must provide expertise in child trauma assessmentand intervention, in the effects of domestic violence on children, and in both adult and child advocacy. We envision this program working closely with established services and taking advantage of other county initiatives, such as efforts to move Family Options programs into the community. HCDCFS' new Structured Decision Making system may play an important role in assessing child safety and making appropriate referrals to this program.
Recommendation 4: Develop new capacity within Hennepin County's Department of Children and Family Services and other County or City agencies to respond to most at-risk cases of child maltreatment in which the mothers are also found to be victims of violence.
The data collected by HCDCFS screeners and investigators revealed that families in which adult domestic violence was known were more likely than others to have their cases opened for County services. Changes in federal law that have shortened the timeline for permanency planning also create a need for changes in practice. These higher risk cases of child maltreatment that also involve adult domestic violence require a more concentrated effort.
Investigation questions that will generate information on adult domestic violence are planned in the County's new Structured Decision Making system. Screeners should also be regularly identifying the extent to which adult domestic violence is occurring in families being reported to HCDCFS.
Once a case is opened for services, the County should take several steps to improve practice with these families. First, it should establish multiple ad hoc Multidisciplinary Child Protection Teams, each formed with County and community-based practitioners working with aspecific family or families. Successfully implementing case-processing protocol agreed to by agency managers (see Recommendation 2) requires regular, on-going meetings between direct service staff in both HCDCFS and other community-based agencies such as battered women's shelters. This work requires cross-communication between agencies regarding specific cases. Formal mechanisms do exist to allow for such discussions. A Multidisciplinary Child Protection Team does exist in Hennepin County but it focuses almost exclusively on child fatality reviews. Forming multiple, ad hod teams with a focus on work with specific families exists in some localities and bring battered women's advocates, child protection workers, probation officers, batterer intervention program staff, police, and other stakeholders to the table to discuss the disposition of specific cases. Some stakeholders have raised the issue of data privacy restrictions but state law (see Appendix C: 626.558, subd. 3) does appear to allow suchexchanges in the context of these teams. Hennepin County's team should be restructured to allow the formation of multiple teams beyond the current one examining child fatalities. The restructuring would allow separate teams or subcommittees to review and coordinate intervention with current cases in which child maltreatment and adult domestic violence are co-occurring. Additionally, better coordination of existing computerized databases that allowcross sharing of information is badly needed within the County (the proposed Common Client Index may provide a solution to this).
HCDCFS should also establish internal expertise on domestic violence and its effects on both mothers and their children. This could be modeled after Massachusetts' efforts where domestic violence specialists who are employees of the child protection agency consult on cases and service plans and also provide training across the system (see Whitney & Davis, 1999).
Responding to families in which there is co-occurring violence is not just the task of a single County agency. There are a variety of coordinated efforts that should occur between and within agencies. These agencies include the County Attorney's Office and how it responds to criminal charges of domestic assault and civil issues of child maltreatment within the same families. Community Health in both the County and City distribute funding to a number of community agencies providing domestic violence services and could, with coordination, help shape that network of services to better meet the needs of this specific group of families. Adult Corrections often supervises the perpetrators of criminal violence against other adults and children. In at least one county (San Diego) they are co-located in the CPS agency and work as a team with child protection workers who are supervising families where felony level assaults have occurred (see NCJFCJ, 1999).
Last, but not least, the courts are often influential in the direction of county services to most at-risk cases of violence. The juvenile and criminal courts must be coordinated with eachother and also better understand the options available in County agencies and community-based services. This last point is especially important because in some cases courts will contradict one another, with one court mandating custody visitation by a convicted perpetrator while another has established a no-contact Order for Protection precluding contact between perpetrator and adult and child victims.
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